Tobacco Use and Heart Health

Million Hearts highlights clinician-led treatment as a proven way to help smokers quit and lower their risk of heart disease and stroke.

The Million Hearts Tobacco Cessation Change Package video, a five-minute tutorial for clinicians featuring Dr. Brenna VanFrank of CDC's Office on Smoking and Health.

How smoking harms the heart

People who smoke are at greater risk of diseases of the heart and blood vessels, including heart disease and stroke. Even people who smoke fewer than five cigarettes a day are at increased risk, and the risk rises with the number of cigarettes a day and the number of years of smoking.

Secondhand smoke also raises the risk of heart disease and stroke. People who already have heart disease are especially vulnerable and should avoid even brief exposure.

Comprehensive smoke-free laws, which ban smoking in workplaces and public places such as bars and restaurants, improve the health of workers and the public and end involuntary exposure to secondhand smoke. They have been shown to greatly reduce hospitalizations for heart attacks among nonsmokers, to keep nonsmokers from starting, and to motivate smokers to quit.

Quitting pays off quickly

For most people who quit, the damage to the heart and blood vessels can be repaired quickly, and even longtime smokers see rapid improvements:

• within a year, the risk of heart attack drops dramatically;
• within five years, most former smokers have cut their risk of stroke to nearly that of a nonsmoker.

Quitting is hard and may take several attempts. Counseling from a clinician and medication are proven treatments, yet in 2015 only 57% of current smokers said a health professional had advised them to quit, and only 29% used medication.

Help for clinicians and health departments

Million Hearts offers clinicians a Tobacco Cessation Change Package of process improvements for outpatient, inpatient and behavioral health settings, protocols for identifying and treating patients who use tobacco, and an action guide for busy clinicians. For public health, it provides a tool kit for municipalities, and CDC's Best Practices for Comprehensive Tobacco Control Programs helps states plan effective programs. The U.S. Preventive Services Task Force (January 2021) recommends that clinicians ask all adults about tobacco use, advise them to quit, and provide behavioral support and FDA-approved medication.

Help for people who want to quit

• 1-800-QUIT-NOW (1-800-784-8669): free quit coaching, a quit plan, educational materials and referrals to local resources.
• 1-855-DÉJELO-YA (1-855-335-3569): the same support in Spanish.
• Asian Smokers' Quitline: Chinese (Cantonese and Mandarin) 1-800-838-8917; Korean 1-800-556-5564; Vietnamese 1-800-778-8440.
• Smokefree.gov: tips, tools and expert advice, free text-message programs, a seven-step quit plan builder and free smartphone apps.

Sources

• Million Hearts, U.S. Department of Health and Human Services, "Tobacco Use." https://millionhearts.hhs.gov/about-million-hearts/building-communities/tobacco-use.html
• CDC, quit attempts and cessation treatment, 2015 (MMWR): https://www.cdc.gov/mmwr/volumes/65/wr/mm6552a1.htm
• Smokefree.gov: https://smokefree.gov/
• The film is the agency's own low-resolution copy, recovered from the Internet Archive's record of cdc.gov.